Turkish bird flu outbreak raises questions

http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20060130/bird_flu_060130/20060130?hub=Health

With word Sunday that all but three surviving avian flu cases have been discharged from Turkish hospitals, questions are swirling over whether the world has overestimated the virulence of the H5N1 virus.

Some wonder if the fatality rate in the Turkish outbreak -- four of 21 cases, if all are confirmed -- is proof the assessment of the virus's virulence has been skewed by a failure to detect mild, even symptomless cases in the other countries where human infections have been recorded.

Could H5N1's high death toll -- stubbornly hovering over 50 per cent -- be the product of faulty math? Of not using the right denominator to calculate the rate? snip

Those who hold the belief that the known H5N1 cases are probably the tip of the iceberg cite a recent study by Swedish researchers to bolster their argument.

The article, published this month in the Archives of Internal Medicine, reported that people who lived in Vietnamese villages which had outbreaks of H5N1 in poultry were more likely to recall having suffered "flu-like symptoms'' than people who were not exposed to poultry.

the survery was subjective ie "do you recall flulike sx".
from here
http://lfpress.ca/newsstand/News/International/2006/01/30/1417590-sun.html
Even if the London lab confirms all 21, the evidence from the outbreaks in Southeast Asia and China paints a different picture: a high death rate and very little sign of the type of mild infections that might initially evade detection.

"The evidence for widespread asymptomatic infections is just not there," says Michael Perdue, a scientist with the World Health Organization's global influenza program in Geneva.

Certainly the odd case here and there probably went unnoticed, the experts assume. Mild cases are more likely to fall through the surveillance net than severe ones.

But a number of studies have been done in Vietnam, Thailand and Indonesia looking for antibodies to the virus in the blood of people who were exposed but who didn't show signs of being ill, including chicken cullers, relatives of known cases and hospital staff who cared for H5N1 patients.

"And they essentially found zero. They haven't found any," says Dr. Scott Dowell, director of global disease detection and preparedness at the U.S. Centers for Disease Control in Atlanta.



It is really interesting to watch the slow spread of this flu. I wish I had a crystal ball and could see how it ends up. I find it alarming that there are so few asymptomatic people via blood tests that had a mild case. I am not sure what it means or portends for the long run.

You don't have to be a master intellect to divine the conspicuous lack of scientific consistency in the recent hysteria surrounding avian flu, to which we are being daily subjected. It really doesn't add up, does it? Honestly, how can anyone seriously believe what we are being told: Avian flu is caused by a distinct new virus - H5N1;it's a real threat;
60 people have died worldwide from it, so therefore 30% of the world's population is in danger of extinction;
millions of birds have died from it, and soon it will mutate to a human form;drugs and vaccines will save us;
the threat is imminent - no time to lose.
Historical context is certainly relevant: avian flu is right on schedule, with the winding down of the post 9/11 smallpox vaccine and SARS vaccine programs. In these two instances, appropriate hysteria was whipped up, billions were spent, and magically - poof! - both threats disappeared. Some background may be helpful.
The first cases of avian flu were reported in Hong Kong in 1997, supposedly with 8 deaths. Then it faded away and did not appear again in Hong Kong until Feb 2003 when there were how many new cases in the outbreak? One. That's one single case. Some pandemic. The disease goes away completely for 6 years and when one new case finally pops up, they start talking pandemic. That's marketing.
Ask yourself: who would benefit from the threat of pandemic?
The only medicine, we are told, which reduces the symptoms of avian flu is a drug called Tamiflu. Today Pharmaceutical giant Swiss Roche holds the sole license to manufacture Tamiflu. Due to the panic, the order books at Roche are filled to overflowing.
However, the real point of interest is the company in California which developed Tamiflu and gave the marketing rights for its patented discovery to Roche.
Tamiflu was developed and patented in 1996 by a California biotech firm, Gilead Sciences Inc. Gilead Sciences is no small-time biotech startup. Its board today includes Bechtel Corp director and former secretary of state George Shultz. Gilead is a NASDAQ-listed stock company which prefers to maintain a low profile in the current rush to Tamiflu. That might be because of who is tied to Gilead. In 1997, before he became Pentagon chief, Donald Rumsfeld was named chairman of the board of Gilead Sciences, where he remained until early 2001 when he became defense secretary. Rumsfeld had been on the board of Gilead since 1988, according to a 1997 company press release.
Rumsfeld holds a Gilead stake valued at between $5 million and $25 million, according to his federal financial disclosures. In the past six months, the global rush to buy Tamiflu has sent Gilead's stock from $35 to $47 - amounting to a windfall of at least $1 million for Rumsfeld. And now, with Gilead collecting royalties averaging 10% from Roche's sales of Tamiflu, he is poised to reap more gains for a flu panic his administration has done everything it can to promote.
President Bush had ordered the US government to buy $2 billion worth of Tamiflu - that was before his November 1 speech calling for another $1 billion worth.
No matter who says what, avian flu bears not the slightest resemblance to anything that could remotely be described as pandemic, nor is it likely to. At present, with the exception of 60 cases in 8 years in 6 billion people, it only affects birds, remember? There is no pandemic, epidemic or mini-demic among humans. And no amount of media repetition can make it so.
Just as nature abhors a vacuum new funding requires new threats. As with the marketing of smallpox vaccine in 2002 and the marketing of SARS in 2003, it's a fairly safe bet the threat of avian flu will disappear as soon as the money has been spent stockpiling the drugs and vaccines. That's the usual pattern. Count on it.